共商用药计划在（SIMPLIfy）居家安养院：一个使居家安养院的处方与目标一致的教育项目。
Shared Medication PLanning In (SIMPLIfy) Home Hospice: An Educational Program to Enable Goal-Concordant Prescribing In Home Hospice.
机构信息
University of Massachusetts Medical School, Worcester, Massachusetts, USA.
College of Nursing, University of Utah, Salt Lake City, Utah, USA.
出版信息
J Pain Symptom Manage. 2021 Nov;62(5):1092-1099. doi: 10.1016/j.jpainsymman.2021.05.015. Epub 2021 Jun 5.
CONTEXT
Simplifying medication regimens by tapering and/or withdrawing unnecessary drugs is important to optimize quality of life and safety for patients with serious illness. Few resources are available to educate clinicians, patients and family caregivers about this process.
OBJECTIVE
To describe the development of an educational program called Shared Medication PLanning In (SIMPLIfy) Home Hospice.
METHODS
An environmental scan identified a state-of-the-art educational program for home hospice deprescribing that we adapted using a stakeholder panel engagement process. The stakeholder panel (two hospice administrators, three nurses, two physicians, two pharmacists, and two former family caregivers) drawn from two geographically diverse hospice agencies reviewed the educational program and recommended additional content.
RESULTS
Iterative rounds of review and feedback resulted in: 1) a three-part clinician educational program (total duration = 1.5 hour) that presents a standardized, goal-concordant, medication review approach to align medications and conversations about regimen simplification with patient and family caregiver goals of care; 2) a patient-family caregiver medication management educational notebook that presents common symptoms, hospice medications, and medication regimen simplification principles; and 3) a brief guide including helpful phrases to use as conversation starters for key steps in the program. A professional designer created thematic coherence for all materials that was well received by stakeholder panelists and hospice staff.
CONCLUSION
Educational materials can support hospice programs' and clinicians' efforts to implement goal-concordant medication simplification that optimizes end-of-life outcomes for patients and family caregivers. Evaluation of outcomes including medication appropriateness and family caregiver medication administration burden are not yet available.
背景
通过逐渐减少和/或停止不必要的药物来简化药物治疗方案，对于优化重病患者的生活质量和安全性非常重要。但是，用于教育临床医生、患者和家属护理人员的资源很少。
目的
描述一种名为 Shared Medication PLanning In（SIMPLIfy）Home Hospice 的教育计划的开发。
方法
环境扫描确定了一种针对家庭临终关怀药物减少的最先进的教育计划，我们使用利益相关者小组参与过程对其进行了改编。利益相关者小组（两名临终关怀管理员、三名护士、两名医生、两名药剂师和两名前家属护理人员）来自两个地理位置不同的临终关怀机构，他们审查了教育计划并推荐了其他内容。
结果
经过几轮反复审查和反馈，最终形成了：1）一个三部分的临床医生教育计划（总时长为 1.5 小时），该计划提出了一种标准化、与目标一致的药物审查方法，使药物和关于方案简化的对话与患者和家属护理人员的护理目标相协调；2）一个患者-家属护理人员药物管理教育笔记本，介绍常见症状、临终关怀药物和药物方案简化原则；3）一个简短的指南，包括有用的短语，作为计划关键步骤的对话起点。一位专业设计师为所有材料创建了主题一致性，得到了利益相关者小组和临终关怀工作人员的好评。
结论
教育材料可以支持临终关怀计划和临床医生努力实施与目标一致的药物简化，从而优化患者和家属护理人员的临终结局。尚未获得包括药物适当性和家属护理人员药物管理负担在内的结果评估。
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